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Craig Acomb of the Minnesota Health Department on Thursday defends the first day of operation for Minnesota FluLine. Many callers who thought they had the flu reported lengthy delays be-fore nurses returned calls. Tribune photo by Don Davis

ST. PAUL -- Health officials are scrambling to expand a hotline for Minnesotans suffering from the flu after callers to the new service reported the telephone went unanswered, they received busy signals and there were hours-long waits before nurses called back.

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More than 100 calls poured into the Minnesota FluLine each of the first few hours it operated.

"We're just asking for the public's patience and understanding," Acomb added.

At mid-day Wednesday, the Health Department announced it had hired the Children's Physician Network to handle the FluLine. The network is a coalition of doctors in more than 220 clinics in an 11-county Twin Cities area. It is being paid up to $2.5 million in federal funds to run the hotline.

Acomb said the Health Department does not have someone constantly in the call center, which is at an undisclosed location, and he did not know much about the problems.

However, the Twins Cities media heard from the sick who said they repeatedly got a busy signal when they called, and once they got through were told it might take a nurse 13 hours to call back.

Acomb said the public should expect to wait five to six hours before a nurse can return a call. But when announcing the hotline on Wednesday, health officials left the impression that callers would reach a screener, then be transferred to a nurse.

"I apologize for that," Acomb said.

Health Department officials said they assumed, but did not know, that all 50 telephone lines were staffed since the hotline opened at 11 a.m. Wednesday.

They said the physician network was trying to add outgoing lines so nurses returning calls would not block new callers to the service. There also was an effort to add more nurses to the service, although on Wednesday health officials had assured reporters that the network had enough nurses available.

Acomb said that people who think they have an emergency situation should call 911 instead of the FluLine.

The FluLine number is (866) 259-4655.

Health officials said the heavy FluLine use showed it is needed.

"We are delighted there is so much interest in that call line," State Epidemiologist Dr. Ruth Lynfield said.

"We had no way to anticipate the volume of calls that we got," Acomb said.

The hotline was established so people who think they might have the flu could call a nurse and get advice about what to do. Those who sound seriously ill could be sent to a clinic or emergency room right away, while others were to be given advice such as stay home and drink plenty of fluids.

Nurses in the program also can prescribe anti-flu medication, such as Tamiflu, if warranted.

In many cases, those calling the FluLine were supposed to be transferred to nurse lines operated by clinics or insurance companies. Others were to be helped by nurses funded by a $2.5 million federal grant.

Also Thursday, three more deaths from the H1N1 flu were reported.

The deaths were in Martin, Steele and Freeborn counties, all in southern Minnesota. Two were children younger than 7, while the Martin County death was a woman in her early 60s. All had other health problems, Lynfield said.

The state did not confirm that Saturday's death of Oliver Franklin Finley, 11, of Hastings was due to H1N1, also known as swine flu. His mother says he died of complications from the H1N1 flu virus.

Lynfield said she could not confirm the cause of death, but said her department waits until it can conduct tests and talk with the medical examiner before officially deciding on a cause.

With Thursday's report, 10 Minnesotans have died of the pandemic flu, with 611 others hospitalized.

While seasonal flu vaccine is available for most Minnesotans, vaccine for the N1H1 variety is scarce.

The Health Department also said that 230 schools reported outbreaks of flu-like illnesses last week, up 15 from a week earlier.

Don Davis has been the Forum Communications Minnesota Capitol Bureau chief since 2001, covering state government and politics for two dozen newspapers in the state. Don also blogs at Capital Chatter on Areavoices.